July 2008 Archives

Building-related illnesses are those for which there is a clinically defined illness of known etiology. These include infections such as legionellosis and allergic reactions such as hypersensitivity diseases and are often documented by physical signs and laboratory findings. Building-related illnesses are uncommon and are more serious in prognosis than mere discomfort. Physician diagnosis by clinical investigation of symptoms is the usual means of recognizing them. These illnesses can have a long latent (or asymptomatic) period after exposure begins before symptoms are experienced, similar to lung cancer after indoor radon exposure. Other categories of building-related illnesses, however, are associated with an immediate appearance of symptoms after exposure. They include toxic illness such as carbon monoxide poisoning; infectious diseases such as Legionella or Legionnaires' disease; and allergic disease such as asthma, hay fever, or hypersensitivity pneumonitis.

Solutions to Sick Building Syndrome (SBS) usually include combinations of the following. First, pollutant source removal or modification is an effective approach to resolving an IAQ problem when sources are known and control is feasible. Examples include routine cleaning and replacement of air filters in HVAC systems; replacement of water-stained ceiling tile and carpeting; venting contaminant source emissions to the outdoors; storage and use of paints, adhesives, solvents, and pesticides in well-ventilated areas, use of these pollutant sources during periods of non-occupancy; and allowing time for building materials in new or remodeled areas to off-gas pollutants before occupancy. Several of these options may be exercised at one time. Second, increasing ventilation rates and air distribution can often be a cost-effective means of reducing indoor pollutant levels. HVAC systems should be designed, at a minimum, to meet ventilation standards in local building codes. However, many systems are not operated or maintained to ensure that these design ventilation rates are provided. In many buildings, IAQ can be improved by operating the HVAC system to at least its design standard, and to ASHRAE Standard 62-1989 if possible. Third, when there are strong pollutant sources, local exhaust ventilation may be appropriate to remove contaminated air directly from the building. Local exhaust ventilation is particularly recommended to remove pollutants that accumulate in specific areas such as rest rooms, copy rooms and printing facilities.

Employee complaints can be due to two types of building problems: Sick Building Syndrome (SBS), and building-related illnesses. SBS is used to describe situations in which building occupants experience acute health effects that appear to be linked to time spent in a building, but no specific illness can be identified. SBS is associated with complaints of discomfort including headache, nausea and dizziness; eye, nose, throat, and respiratory irritation; coughing; difficulty concentrating; sensitivity to odors; muscle pain; and fatigue. The specific causes of the symptoms are often not known but sometimes are attributed to the effects of a combination of substances or individual susceptibility to low concentrations of contaminants. Symptoms of SBS are associated with periods of occupancy and often disappear after the worker leaves the worksite.

While pollutants commonly found in door air are responsible for many harmful effects, there is considerable uncertainty about what concentrations or periods of exposure are necessary to produce specific health problems. People also react very differently to exposure to indoor air pollutants. Comprehensive worker protections provided pursuant to OSHA, discussed below, are not considered particularly stringent. Where there have been competing regimes, whether by EPA or state agencies, these agencies have generally set standards that are occasionally orders of magnitude more stringent than those set by OSHA.

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